Assessment of changes in pharmaceutical performance among primary health care health facilities that received technical assistance in a rural district of the Eastern Cape, South Africa
Year: 2019
Type: article
Abstract: ResultsDifferences in facility support visit frequencies between the four sub-districts in Amathole District were significant (X 2 (39, n =110) = 98.5, p<0.001), suggesting that the programme was not uniformly implemented across all sub-districts.Although statistically significant improvements occurred in five facility pharmaceutical functioning domains (Guidelines and http://etd.uwc.ac.za/ iii reference materials availability, Training, Stock management, Stock monitoring, and Storage of medicines) and the overall total score, the expired medicine and stockout domains reflected deterioration.Thus the programme overall was effective, but outcomes on stockouts and expiries were questionable, and may point to facility-level challenges with stock card data accuracy.A significant correlation was found between the frequency of support visits and change in facility level pharmaceutical performance [r = 0.248, n =110, p =0.009].Therefore, a relationship between the intensity of support visits and improvement in facilitylevel pharmaceutical performance was found. ConclusionsDespite an overall improvement in pharmaceutical performance, absence of a consistent improvement in the stockout and expiry domains points to the complexity of pharmaceutical and health system functioning, and focused interventions at facility level may be too limited when systemic challenges extend beyond the facility.TA interventions added value, however, to be effective, these need to be implemented in a sustained, systematic manner. RecommendationsUnintended reinforcing of inequity between rural and urban areas is a risk in programme implementation.Therefore, close monitoring, and possible re-direction, of programme support rendered is core to ensuring facilities in urban and rural areas receive equitable support.Since there is a risk of bias or inaccuracy of stockout data obtained from bin card records at facility level, independently obtained stockout data (to triangulate with facility level data) is recommended.Future analysis could explore the association between TA strategy employed and improvement in facility functioning, and an optimal threshold of visit frequency.This would direct optimal use of programme resources.
Author: Jallow, Carmen
Language: English
Subfield: Pharmacy
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3161483735